Hyperintense Vessel Signs on FLAIR MRI as a Predictor of Early
Neurological Deterioration in Patients with Acute Posterior Circulation
Infarction

J Korean Neurol Assoc > Volume 29(4); 2011 > Article

Journal of the Korean Neurological Association 2011;29(4): 309-316.

후방 순환 뇌경색 환자에서 초기 신경학적 악화의 예측 인자로서 액체감쇠역전회복 자기공명영상의 고신호혈관징후

김동은, 김준태 조방훈 이세영 최강호 박만석 조기현

전남대학교 의과대학 신경과학교실, 뇌혈관센터

Hyperintense Vessel Signs on FLAIR MRI as a Predictor of Early Neurological Deterioration in Patients with Acute Posterior Circulation Infarction

Dong-Eun Kim

Department of Neurology, Cerebrovascular Center, Chonnam National University Medical School, Gwangju, Korea

Abstract

Background: Hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery imaging (FLAIR) is an indicator of slow flow and early ischemia. This study tested the hypothesis that HVS in the posterior circulation is associated with a worse outcome.
Methods: We retrospectively included 64 stroke patients with posterior circulation steno-occlusion within 6?hours of symptom onset and reviewed early neurological deterioration (END). END was defined as an increase in National Institutes of Health Stroke Scale (NIHSS) score of 4 or more from baseline during the first week. We analyzed demographic and laboratory information followed by an assessment of the magnetic resonance images. In addition, we assessed the posterior circulation Albert Stroke Program Early CT Score (pc-ASPECTS) on diffusion-weighted imaging (DWI).
Results: Among the 64 patients who met the inclusion criteria, END was seen in 17 patients. On univariate analysis, these END patients had higher baseline NIHSS scores and elevated initial systolic blood pressure (iSBP). Multiple logistic regression analysis revealed pc-ASPECTS (p=0.007), HVS on FLAIR (p=0.011), and iSBP (p=0.016) as independent predictors of END.
Conclusions: The presence of HVS on FLAIR in the posterior circulation might indicate the presence of more severe ischemic penumbrae and END. pc-ASPECTS may also be an independent predictor of functional outcome. Key Words: Fluid-attenuated inversion recovery imaging (FLAIR), Early neurological deterioration (END), Posterior circulation infarction, Albert Stroke Program Early CT Score (ASPECTS)